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WORLD DIABETES DAY 2017: WOMEN and DIABETES Online Registration Closes November 13

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WORLD DIABETES DAY 2017: WOMEN and DIABETES Online Registration Closes November 13 Diabetes Voice GLOBAL PERSPECTIVES ON DIABETES Volume 64 Issue 3 October 2017 WORLD DIABETES DAY 2017: WOMEN AND DIABETES Online registration closes November 13 Shape the future of diabetes www.idf.org/congress #IDF2017 CONTENTS DIABETES VIEWS GLOBAL CAMPAIGN 4 Diabetes is a serious women’s health issue 23 IDF Congress 2017: Scientific Dr. Sania Nishtar Programme Manny Hernandez, Hak Chul Jang, Massimo NEWS IN BRIEF Massi Benedetti 6 IDF launches global survey on CVD awareness HEALTH DELIVERY 27 Lessons from WINGS 11 La Comunidad: community-based Belma Malanda diabetes prevention CLINICAL CARE Diabetes in pregnancy: an opportunity 12 ADA and JDRF lead hurricane relief 30 for healthy change Jessica Lynn 13 Argentina: YLD member meets with Governor Online registration DIABETES IN SOCIETY 33 Women living with type 1 diabetes go Ecuador: Congress highlights 14 the distance Diabetes education key for Erin Spineto closes prevention–growth–empowerment November 13 35 Type 1 diabetes and pregnancy SPECIAL FEATURES: WOMEN AND Ginger Vieira DIABETES 16 All women with diabetes deserve the right to a healthy future 17 Women with diabetes around the world International Diabetes Federation © International Diabetes Federation, 2017 - All rights reserved. No part Promoting diabetes care, prevention and a cure worldwide of this publication may be reproduced or transmitted in any form or by Editor-in-Chief: Douglas Villarroel any means without the written prior permission of the International Editor: Elizabeth Snouffer Diabetes Federation (IDF). Requests to reproduce or translate IDF Editorial Coordinator: Lorenzo Piemonte publications should be addressed to [email protected]. Design and layout: Karen Joup The material in this document is for information purposes only. IDF All correspondence should be addressed to: makes no representation or warrantires about the accuracy and Elizabeth Snouffer, Editor reliability of any content in the document. Any opinions expressed are those of their authors, and do not necessarily represent the views of International Diabetes Federation IDF. IDF shall not be liable for any loss or damage in connection with Chaussée de La Hulpe 166, 1170 Brussels, Belgium your use of this document. Through this document, you may link to Tel: +32-2-538 55 11 | Fax: +32-2-538 51 14 third-party websites, which are not under IDF’s control. The inclusion Shape the future of diabetes [email protected] of such links does not imply a recommendation or endorsement by IDF of any material, information, products and services advertised on Diabetes Voice is available online at www.diabetesvoice.org third-party websites, and IDF disclaims any liability with regard to your Cover photo: iStock photo www.idf.org/congress #IDF2017 access of such linked websites and use of any products or services advertised there. While some information in Diabetes Voice is about medical issues, it is not medical advice and should not be construed as such. DIABETES VIEWS Diabetes is a serious women’s health issue Dr. Sania Nishtar I recently had the privilege and the opportunity of age. Two of Rehmat’s sisters are on dialysis, due to end- travelling around the world as one of the three nominees stage diabetes-related renal disease, and already one sister for Director-General of the World Health Organization has undergone a heart bypass operation unsuccessfully. All (WHO). Wherever I went, in addition to presenting my sisters suffer from serious damage to their eyes—another candidature, I utilised the opportunity to visit hospitals, complication of diabetes. The burden of care for the entire hospices, primary healthcare centres and communities— extended family in emotional, physical and economic and everywhere, I found the footprint of diabetes terms is devastating. The opportunity cost weighs heavily disturbingly ubiquitous. The official figures are estimated in terms of the wellbeing and future outlook for their at 415 million adults currently living with diabetes and respective families. these estimates are projected to increase to 642 million by 2040. Approximately 199 million women live with The ravages of diabetes are not confined to the realm of diabetes which is projected to rise to 313 million by 2040.1 noncommunicable diseases (NCDs) alone. In technical I fear this may just be the tip of the iceberg. and public health parlance, diabetes is clubbed together with the other NCDs, and is as such siloed outside of the Girls and women with diabetes experience a range mainstream public health, which is still dominated by of challenges. Power dynamics, gender roles and infectious diseases and reproductive and maternal and socioeconomic inequalities influence vulnerability to child health (RMNCH). It is imperative that we recognise diabetes, such as by exposing women to poor diet and diabetes as an issue that straddles both RMNCH as well nutrition and physical inactivity disproportionately. as NCDs, as diabetes is a serious and neglected threat to These factors also affect women’s access to health services the health of mother and child. Two out of five women and health seeking behaviour, and amplify the impact of diabetes on women, particularly in developing countries. Diabetes is one of the leading causes of cardiovascular disease (CVD), blindness, kidney failure and lower-limb It is imperative that we amputation. In pregnancy, poorly controlled diabetes increases the risk of maternal and fetal complications. recognise diabetes as an issue Diabetes is the ninth leading cause of death in women that straddles both RMNCH as globally, and causes 2.1 million deaths per year. Women well as NCDs with type 2 diabetes are 10 times more likely to have heart disease and have significantly increased risk of depression in comparison to men. Globally, there are more deaths with diabetes are in reproductive age and half of all cases attributable to diabetes in women than men. of hyperglycaemia in pregnancy occur in women under the age of 30, accounting for over 60 million women These are not mere statistics, but facts which incur heavy worldwide. One in seven births is affected by gestational physical and emotional and economic toll on families. The diabetes (GDM). IDF estimates that 20.9 million or a suffering of four sisters in my country, Pakistan, epitomizes staggering 16.2% of live births in 2015 had some form of the problem millions of women face worldwide. At 44 hyperglycaemia in pregnancy. Women with diabetes have years, Rehmat is the youngest of four sisters—all of more difficulty conceiving and may have poor pregnancy whom are obese. Recently Rehmat was hospitalised for a outcomes. Many women with GDM experience pregnancy diabetic foot amputation, a common and tragic outcome related complications including high blood pressure, large of uncontrolled diabetes, which will place great difficulties birth weight babies and obstructed labour. A significant and challenges for her ahead, being so scarred at a young 4 Diabetes Voice Online Volume 64 - Issue 3 - October 2017 DIABETES VIEWS number of women with GDM also go on to develop type 2 Antenatal care visits during pregnancy must be optimised diabetes resulting in further healthcare complications and for health promotion in young women and early detection costs. of diabetes and GDM. Most alarming is that the vast majority of cases of We can no longer afford to treat diabetes and NCDs as the hyperglycaemia in pregnancy have been found to be blind spot of our policies. There must be a conscious effort in low- and middle-income countries, where access to to drive change. Constituents of IDF can be the drivers maternal care is limited. GDM can also leave its mark on of that change. They must marshal the much-needed women for life, as approximately half of women with a momentum now, and as a matter of right, not choice, not history of GDM go on to develop type 2 diabetes within options. five to ten years of delivery. Women with type 1 diabetes have an increased risk of early miscarriage or having a baby with malformations, in any case. There is, however, a silver lining to this problem. We know that the majority of cases of type 2 diabetes could be prevented through the adoption of a healthy lifestyle. Approximately, seventy percent of premature deaths among adults are largely due to behaviour initiated during adolescence which is where the potential of lifestyle modification is greatest. This is where the role of women and girls is critically important as they are the key agents in the adoption of healthy lifestyles to improve the health and wellbeing of future generations. As gatekeepers of household nutrition and lifestyle habits they have the potential to drive prevention from the household and beyond. For all these reasons, I would like to lend my voice of support to IDF’s message on World Diabetes Day to its constituencies—a network of thousands of foundations and societies all over the world. This network has an enormous influence to cascade IDF messages in their countries to governments, policymakers, civil society, the scientific community and people in general to catalyse a whole of societies approach to tackling this challenge. At a broader public health and health systems level, Dr. Sania Nishtar of Pakistan is a former federal minister and diabetes prevention and management, along with extensive prominent global health leader with extensive experience measures aimed at NCD prevention and control need in public healthcare. She was among the three candidates to be mainstreamed in country planning with adequate nominated for the post of Director-General of the World Health attention to the specific needs and priorities of women Organization (WHO) in 2017. with diabetes. Women and girls should be empowered with access to knowledge and resources to strengthen their capacity to prevent type 2 diabetes in their families and better safeguard their own health. In addition, type 2 diabetes prevention strategies must focus on maternal 1.
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